• 한국의학물리학회지:의학물리
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• 제25권1호
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• pp.8-14
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• 2014

의료분야에서 방사선 진료기술의 발전에 따라 방사성폐기물의 수량은 급속히 증가하고 있다. 방사성폐기물에는 주로 PET/CT에 사용하는 $^{18}F$을 비롯하여 핵의학검사에 사용하는 $^{99m}Tc$ 등과 같이 반감기가 매우 짧은 방사성동위원소가 함유되어 있다. 이를 처분하기 위하여 국제원자력기구(IAEA)는 개인선량($10{\mu}Sv/y$) 및 집단선량(1 man-Sv/y)과 핵종별 농도에 근거하여 각각 폐기물의 규제해제기준을 제시(IAEA Safety Series No 111-P-1.1, 1992 및 IAEA RS-G-1.7, 2004)하였다. 이 연구에서는 IAEA 기준에 따른 방사능농도를 측정하기 위하여, $^{18}F$, $^{99m}Tc$, $^{123}I$, $^{125}I$ 및 $^{201}TI$ 관련 방사성폐기물을 수집하고 측정용기를 준비하였다. 그리고 MCA를 이용한 감마방사능 측정, 감마계수기를 이용한 감마방사능 측정, 베타입자 방출 핵종의 방사능 측정방법 및 절차를 수립하고, 표준물질을 제작하여 교정하였다. 측정결과를 근거로 방사능 감쇠 유도식을 산출하였으며, 이를 이론식과 대비하여 고찰하였다. 이 연구 결과는 ISO 표준으로 추진할 예정이다.

• 한국방사선학회논문지
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• 제11권4호
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• pp.289-295
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• 2017

일반적으로 유방암 발생에 영향을 미치는 요소는 여러 연구가 진행되었으나 위험인자에 관한 체계적인 조사는 드물다. 따라서 본 연구에서는 유방초음파 검사 전 실시하는 건강문진표 작성내용과 실제 초음파 검사에서 유방암 판정을 받은 환자를 바탕으로 관련인자를 파악하고자 하였다. 유방초음파를 실시한 417명을 대상으로 자기기입식 문진표를 작성하였고 양성, 악성으로 분류하여 후향적 연구를 시행하였다. 유방암 발생 관련인자로 나이, 체질량지수, 투약 종류에서 관련성을 보였으며(p<0.05), 다변량분석 결과 교차비(Odds ratio)는 나이에서 50대 이하를 기준으로 50대에서 4.93배, 체질량지수 정상군보다 비만군에서 2.43배 증가하였고 타목시펜과 여성호르몬제 투약 시에는 0.14배, 0.16배 감소하였다(p<0.05). 따라서 나이가 증가함에 따라 정기적인 검사를 실시하고 적절한 체중관리가 필요하다. 따라서 본 연구는 유방암 발생에 영향을 미치는 위험인자 규명의 기초자료로 제공될 것으로 기대한다.

• 여성건강간호학회지
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• 제5권1호
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• pp.133-145
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• 1999

The purposesof the study are to analyze the community nursing center in U.S.A and to develop the model of nursing care system based on nurse-midwifery clinic in community for women's health in Korea. 1. In America nursing center is defined as nurse-anchored system of primary care delivery or neighborhood health center. Nursing centers are identified the following four types: (1) community outreach centers, which are similar to traditional public health clinics: (2) institutional-based centers following the mission of a large institution, such as a hospital or university: (3) wellness/health promotion centers, which offer screening, education, counseling, triage, and health maintenance services: and (4) independent practice. Nursing centers are a concept of services provided by nurses in practice arrangements in a community. Nursing centers offer a variety of services, ranging from primary care provided by advanced practice nurses with medical acute management and nursing care to the more traditional education, health promotion, screening wellness and coordination services. Some services, such as the care provided by advanced practice nurses are reimbursed under various insurance plan in some instances and states, where as others, such as preventive and educational services, are not. Thus, lack of reimbursement has threatened the survival of some centers. Licensing of nursing centers varies by state and program and accreditation of nursing centers is also limited. 52% of centers are affiliated with another facility and 48% are freestanding centers. The number of registered nurse at the nursing centers ranges from just one to 115, with a mean of eight RNs peragency and a median of three. Nursing centers avail ability varies: 14% are open 24 hours, 27% have variable short hours, 23% are open 6-7 days per week, and 36% are open Monday- Friday. As the result of my visiting three health centers in Seattle and San Francisco, the women's primary care nurse practitioners focus on a systematic and comprehensive assessment of the health status of women and diagnosis and management of common physical and psychosocial health concerns of women in ambulatory settings. Therapeutic nursing strategies are directed toward self-care, risk reoduction, health surveillance, stress reduction, healthy nutrition, social support, healthy coping, psychological well-being, and pharmacological therapy. They function as primary care providers for the well ness and illness care of women from adolescence through the older adult years and pregnant families. 2. In Korea a nurse-midwife practices independently for pregnant women's health including childbearing family at her own clinic in community. Her services are reimbursed under national health insurance but they are not paid on a fee-for-service schedule covering items. Analyzing the nursing centers in America, I suggest that nurse-midwifery clinics offer primary care for women and home care for chronic ill patients. The health law and health insurance policy should be reovised in order to expand nurse-midwife's and home care nurse's roles at nurse-midwifery clinic.

• 대한불안의학회지
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• 제9권1호
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• pp.31-37
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• 2013

정신장애 진단선별 질문지(PDSQ)는 임상에서 흔하게 진단되는 DSM-IV 축 1의 장애를 평가하기위해 고안된 최초의 자기보고식 질문지이다. PDSQ는 포괄적인 평가가 가능하고, 공존질환을 평가 할 수 있으며 신뢰도와 타당도가 높은 것으로 알려져 있다. 이 연구는 K-PDSQ의 표준화를 위한 연구로서, K-PDSQ와 M.I.N.I.-Plus의 비교를 통해 K-PDSQ의 진단적 타당성과 유용성을 검증하고자 하였다. 계명대학교 동산병원 정신건강의학과를 방문한 외래와 입원환자 640명을 대상으로 K-PDSQ와 M.I.N.I.-Plus의 진단적 일치도, K-PDSQ의 시행시간, 민감도 및 특이도를 산출하였다. K-PDSQ와 M.I.N.I.-Plus의 Cohen's kappa계수는 .66로 일치도가 높게 나타났고, K-PDSQ의 시행 소요시간은 $18.2{\pm}11.80$분이었다. 타당도에 있어 국내 환자군 대상으로 산출된 절단점을 적용하였을 때 높은 수준의 민감도와 특이도를 나타냈다. 대부분의 하위척도에서 수용자 작업특성 곡선(ROC)이 대각선 위에 있었고 곡선아래 영역(AUC) 값이 .80 이상으로 선별검사로서 유용성이 입증되었다. K-PDSQ는 M.I.N.I.-Plus와 상당한 진단적 일치도를 보였고, 시행시간이 짧고, 민감도와 특이도에서 높은 수준을 보였다. 따라서 K-PDSQ는 외래 진료환경에 적용하여 임상면담 이전에 환자에 대한 진단적 평가와 공존질환을 선별해내는데 큰 도움이 될 것으로 생각된다.

• 동의생리병리학회지
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• 제32권2호
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• pp.134-140
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• 2018

This study aims to evaluate healthcare providers' satisfaction and demands pertaining to the collaborative first-stage pilot project between Korean medicine and Western medicine. This survey was conducted via electronic mail among 33 healthcare providers participating in the pilot project. Likert type 5-point scale or Likert type 7-point scale was used to evaluate each item. The response of '${\geq}4$' on the 5-point scale, and '${\geq}5$' on the 7-point scale were analyzed as positive answers. A total of 27 healthcare providers (81.8%) responded, of which 9 were western medical doctors (33.3%) and 18 were Korean medical doctors (66.7%). In respect to satisfaction of the pilot project, 88.9% gave positive responses on improved patients' convenience, 59.3% on treatment efficiency and 55.6% on diagnosis efficiency. In terms of self-evaluation on the pilot project, 70.4% gave positive answers on changes in quality of collaborative treatment, 74.1% on cooperation of results, 63.0% on cooperation of structure and 51.9% on cooperation of process. In terms of demand for collaborative treatment or the pilot project, 'standardized manual' and 'simplification of administrative procedures' showed highest demand, resulting up to 88.9%, followed by 85.2% demanding more public relations and 63.9% demanding enlargement of participating hospitals. This survey revealed that healthcare providers are generally satisfied with patients' convenience and treatment effects. Further studies are needed to develop a standardized manual, simplified administrative procedures, and expanded pilot project contents.

• 지역사회간호학회지
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• 제4권1호
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• pp.14-24
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• 1993

The Purpose of this study was to explore the condition of periodic medical examination and the health care services of industries in order to offer some basic data on developing industrial nursing care. To achieve this goal a self - administered questionnaire (developed by the academic affairs of community health nursing) was provieded to the nurses in 56 industries from Dec. 10, 1992 to Jan. 20, 1993. The statistical computer package, SPSS, was used to manipulate the data along with T-test and ANOVA. The results were as follows : 1. General characteristics: The greater part of the industries were manufacturing company, and below 300 employees of industry were 55.4%. The shift system was mostly one shift(66.1%) and three shift(23.2%), and 50.0% them organized the Industrial Safety and Health Commitee. Average a number of employees was 631 person. 2. Periodic Medical Examination: Most of the workers were receiving periodic medical examination from the designated hospital (95.71%). From the about 12.89% were gone through a colse medical examination. In colse medical examination 58.41% were decided 'C' and 36.73% were decided 'D'. About 6.23% off those who had any clinical findings were work-time shortening(7.84%), work-transition(8.12%), recoverating at home. The majority of the workers receive the result of the periodic medical examination individually (78.5%). 3. Special medical examination: The rate of those who are receiving special medical examination were 76.82% and about 8.24% were decided 'C' and 1.23% were decided 'D' Those who had any health problems were receiving follow-up checking (9.10%) and medical treatment while working (15.04%). The health managers in the company can consult (85.7%) those who had any suspicious sign and symptoms of occupational disease. 4. Health care services: The average score of health care services were 17.57 point out of 28 point, and the score was lower in health assessment and environmental hygiene than medical diagnosis and health education. There were significant differences in environmental hygine (F=3.72, P=0.017), health care services(F=3.94, P=0.013) according to the size of the size of the industries The other's significancy is not shown by any type of industrial nurse. The level of health care services were higher in the wokers who had better health and showed no singificant differences(T=-0.73, P=0.470).

• 지역사회간호학회지
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• 제4권1호
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• pp.58-66
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• 1993

The purpose of this study was to explore the condition of periodic medical examination, and health care services in industries. This will offer some basic data in developing industrial nursing care requirements. To achieve this goal a self-administered questionnaire (developed by the academic affairs of community health nursing) was provided to the nurses working in 40 industries from Dec 20, 1992 to Jan 20, 1993. The statistical computer package SAS, along with t-test, and ANOVA was used to manipulate the date. The results were as follows : 1. General Characteristics: The greater part of the industries studied were manufacturing company, with over 500 employees. The shift system was used with most companies using one or three shifts, and 75.0% of them were organized with Industrial Safety and Health Committees. 2. Periodic Medical Examination : Most of the workers were receiving periodic medical examination from a designated hospital (96.7%). Of those 15.8% had a close medical examination. In the medical examination 9.4% were evaluated at 'C' and 3.8 were evaluated at 'D'. About 55.0% of those workers received the result of the periodic medical examination individually(95.0%). 3. Special Medical Examination : The rate of those who were receiving special medical examination was 98.4% and about 11.7% were evaluated at 'C' and 3.9% were evaluated at 'D'. Those who had any health problems (54.2%) were receiving follow-up care, 52.4% of them had medical treatment while working. The health care managers in the company consulted 97.1% of them who had any suspicious signs and symptoms of occupational diseases. 4. Health Care Services : The average score of health care services was 13.8 out of a possible 28 point. The score of health education and health assessment, was lower than medical diagnosis and environmental hygiene. There were no significant differences in health care services according to the size of the industries(F=.95, P=.429). The score of health care services was higher in the worker who had better health and showed significant differences (F=4.50, p=.025).

• 기본간호학회지
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• 제6권3호
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• pp.493-506
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• 1999

The purpose of the study is to evaluate the effectiveness and competence level of trainees of Cardiopulmonary resuscitation training targeted for nursing students. 70 nursing students of Y nursing college are recruited as subjects from Dec. 1st, 1998 through Dec. 8th. 1998. For the pre-test. demographic data related to CPR and knowledge of CPR were evaluated. For the post-test, the next week of pre-test, three difference groups of subjects were tested their knowledge of CPR. CPR training was designed by two components which were 90 mins lecture and demonstration by one professor and individual practice using two educational models with two professors. As the tool of measurement estimating pre or post knowledge of CPR. questionnaires were developed based on self-diagnosis questionnaires of American Heart Association(AHA). The questionnaires were multiple choices (50 questions) and open end questions regarding CPR process. Each multiple choices questions valued 2 points (Score varied min. 0 point to max 100 points.). Collected data were computerized and analyzed by SPSS-WIN. Frequency and percentage of each questions analyzed. The differences of the knowledge and competency level of subjects between pre and post test was analyses by paired t-test. The followings are research outcome. 1. In the pre-test, 95% of subjects answered that they already knew what CPR was. but only 82% described correctly what CPR was. 49% learned CPR before, and 80s5 of them learned at high school. 2. 37 questions scores increases, and 10 questions scores decreased. 3 questions didnt change their score. After getting training, ratio of 80% correct score significantly increased 4 times. 3. In post-test. knowledge level of trainees increased compared to that of pre-test. (t=-15.075, p=.000) 4. Competence level also increased (t=-14.86, p=.00). In result, after getting CPR training, most CPR knowledge increased except open the air tract, toddler CPR, and alternative behavior when the air tract is blocked. CPR training needs to extend the educational scope not only CPR lecture but also psychomotor skill practice. CPR trainees are in need of appropriate feedback as well as enough opportunities of skill practice.

• 대한불안의학회지
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• 제10권2호
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• pp.176-181
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• 2014

Objective : Despite high prevalence and effective treatments of panic disorder, lots of patients are not properly treated due to lack of awareness of the disorder. This study summarizes and presents the results from Public Awareness Survey of Panic Disorder during the Mental Health Exposition held in Seoul in April, 2014. Methods : A total of 401 participants who visited the booth of the Korean Academy of Anxiety Disorder agreed and completed the survey. The questionnaires comprised of three sections; first, after given a case of patient with panic disorder, participants were asked to choose a diagnosis and treatment options. Second, participants were asked to differentiate the symptoms of panic disorder from those of other mental disorders and answer where they acquired the knowledge of the disorder. Third, visual analogue scales were used to get more detailed information for several issues about panic disorder. The incidence and ratio for each question were provided and compared. Results : Among the participants, 78% reported a patient within the case need treatment, and 30% accurately recognized it was panic disorder. As for treatment needed, 40% selected psychotherapy by psychiatrists, 28% chose counseling by psychologist, 23% said that they can overcome it by self-care. Only 2% of participants selected the pharmacotherapy as treatment needed. Approximately 40% of participants have encountered information about the disorder from gossips of celebrities, 32% from mass-media, and merely 6% from medical professionals. About 80% of participants could discriminate the symptom of panic disorder from those of depression, schizophrenia, or generalized anxiety disorder. Conclusion : Our results suggest that substantial proportions of participants have the awareness of panic disorder, while as for treatment they were strongly biased against pharmacologic treatments. Most of their source of the awareness was not relied upon professional information. Efforts for giving correct information and increasing public awareness of panic disorder are needed to bridge a gap between professionals and general public.

• Clinical and Experimental Pediatrics
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• 제52권5호
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• pp.622-626
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• 2009

키쿠치(Kikuchi) 병, 키쿠치-후지모토(Kikuchi-Fujimoto) 병, 혹은 조직구 괴사성 림프선염은 1972년 일본에서 키쿠치와 후지모토 두 사람에 의해 처음 기술되었으며 흔히 아시아 지역에서 30세 미만의 여성들을 주로 침범하는 자가 관해 질환으로 기술되어져왔다. 이 질환의 병인은 여전히 잘 알려져 있지 않으나 감염성(EBV, HHV-6 and -8, HTLV-1, cytomegalovirus, varicella-zoster virus, tuberculosis, toxoplasmosis, yersiniosis, cat scratch disease), 자가면역성(SLE, Kawasaki disease), 그리고 종양성 질환(lymphoma)이 포함되는 것으로 간주된다. 가장 흔한 임상증상은 발열과 통증 없는 경부 림프선염이다. 진단은 생검을 통한 조직병리학적으로 하게 되는데, 주로 풍부한 핵파괴(karyorrhexis)를 가진 피질 주위 지역에서 나타나는 국소 괴사, 괴사 지역 주위로 비정형적인 단핵구들의 집합, 중성구 및 형질 세포의 결핍, 그리고 대개 림프절 캡슐의 보존 등으로 특징 지워진다. 절대적인 치료법은 없어 대증 치료를 하게 되며 치료 없이도 대개 1-6개월 안에 자가 관해되고 재발률도 3.3%에 불과하다. 키쿠치-후지모토 병의 합병증으로 피부, 심장, 골수 등을 침범할 수 있으며 간질환, 무균성 뇌수막염, 간비비대 등이 발생할 수 있으나 드물다. 본 증례에서는 입원 당시 결핵성 임파선염과 뇌수막염으로 오인되었던 무균성 뇌수막염을 동반한 키쿠치-후지모토 병을 경험하였기에 이에 보고하는 바이다.